The 2nd Hwa To International Symposium (Integration of Eastern & Western Medicine) was held in Amsterdam on the 23rd & 24th of September 2006. “Hwa To” is a name of a famous ancient Chinese doctor, and the sponsor of this symposium is “Hwa To International University of T.C.M.” in Amsterdam. About 200 members participated from 19 countries, and as Japanese speakers Mr. Seino and Watanabe were invited. As the drawing up of the abstract book was not in time for the opening of the symposium, the contents of presentations were not clear except the name of speakers and their themes. Most of the presentations were lecture, and almost all of the lectures were expressed in English, and there were no loss of time by translation from Chinese to English which is usual in the assemblies of WFAS.
The atmosphere of the symposium or the titles of the card of Prof. Rangkuti suggested me that the European society of acupuncture has a tendency to keep aloof from WFAS.

Infection is one of the most serious complications of acupuncture. But no infection ever appears without contamination, so the best method for preventing infection is to avoid contamination.
There are two causes of contamination by acupuncture, namely, unsatisfactory disinfection of skin and contaminated neeedles. The former involves incomplete skin cleaning and inadequate disinfection. The latter is caused by contact with unsanitary matter. Some factors which are usually considered insignificant, such as contamination by needle tube, finger push technique, needle insertion technique or contamination in the needle case, should be re-examined.
The author never touches the part of the needle which can penetrate the skin. This simple measure can help to prevent contamination of needles and consequent infection.

High levels of negative ions have been detected in the air in forests, at spas, near waterfalls, and so forth, and there have been reported that they have a favorable effect on human beings' feeling of comfort and their feeling of fatigue. In this study we prepared an experimental room in which it was possible to maintain temperature constant at 25°C and constant humidity, and turn the supply of negative ions on and off, and in addition to assessing comfort level and fatigue level subjectively, we assessed them by means of the -wave component of the EEG, which indicates the degree of relaxation, and by auditory evoked potential P300, which reflects attentiveness and degree of fatigue.
Methods: The subjects were 15 healthy physicians and nurses. The experiment was conducted in a room maintained at a constant temperature of 25°C and a constant humidity of 50% during a 2-hour period on different days without informing the subjects of whether the air was loaded with negative ions or not. Constant temperature and humidity were maintained, and the level of negative ions was adjusted by using a shinki genertor (Geochto Ltd.). The parameters measured were determined with a flicker test and P300 (auditory evoked) test, and the α-wave ratio was calculated from the 60-minute closed-eye resting EEG.
Results: A higher percentage of subjects reported subjective comfort when the air was loaded with neagtive ions (6/15, 40%) than when it was not (4/15, 27%).
Significant difference was not observed in the P300 tests, but the α₂ (10-13Hz) ratio of the EEG and flicker test tended to be higher with negative ion-air than without nagative ion-air.

We report the case of a 17-year-old male who had involuntary movements treated with yokukansankashakuyakukoboku. He had first recognized the involuntary movement 6 years previously. His symptom could not be alleviated with neurological and psychological treatments, and he visited our clinic for treatment with Kampo medicine. His symptom gradually alleviated with yokukansankashakuyakukoboku. The ancient physician Sekki (薛已) created yokukansan in China's Ming Dynasty. Yokukansan and its various add-on combinations were used in the Edo Era of Japan. Keisetsu Ohtsuka then created yokukansankashakuyakukoboku, which is however now rarely used because there is no extract drug in Japan. There are markedly nervous patients however, who can be treated with this formula. Thus, the authors feel that more research needs to be done on the differences between yokukansan and yokukansankashakuyakukoboku.

We describe the case of an 83-year-old woman who underwent surgical repair for abdominal aortic aneurysm with horseshoe kidney. Preoperative computed tomography (CT) scans showed the presence of not only the principal bilateral renal arteries but 2 accessory renal arteries originating from the right common iliac artery. The left accessory renal artery had 2 branches supplying each of the lower poles of the kidneys. We performed open surgery for artificial graft replacement by dividing the isthmus. The isthmus was formed of fibrous connective tissue therefore we dissected the isthmus sharply and sutured edges. A urinary fistula was absent. Since supply to the right renal lower pole via the left accessory artery was negligible, the artery was ligated. We performed this procedure safely and achieved a successful outcome.

During past 15 years 78 patients were operated for thoracic aortic aneurysm. Patients operated in emergency or dead within 24 hours after operation or with preoperative renal failure were excluded and remaining 65 patients were studied for factors affecting postoperative renal dysfunction. Postoperative renal dysfunction was based on the serum creatinine value which was within normal limit before operation and exceeded 1.5mg/dl after operation, or which increased by 1mg/dl and more from preoperative value. 23 patiens developed postoperative renal dysfunction and the incidence was 35.4%. As preoperative factors, old age, male and high value of preoperative serum creatinine were significantly (p<0.01) related with postoperative renal dysfunction. As intraoperative factor, decreased urine output per operative hour was significantly (0.01<p<0.05) related. Other preoperative factors; hypertension, diabetes, location of aneurysm, dissecting and nondissecting, intraoperative factors; operation time, volume of operative bleeding, minimum systolic blood pressure during operation, clamping time of aorta, minimum temperature of rectum, difference of adjuncts (temporary shunt or extracorporeal circulation), postoperative factors; systolic blood pressure at arriving ICU, urine output of first postoperative day were not significantly related. Between the operative procedures of graft replacement and extraanatomic bypass, no significant difference was recognized in occurrence of postoperative renal dysfunction, but patients with patch angioplasty etc. developed no renal dysfunction. In the complications within one week after operation, central nervous system dysfunction, infection and hemorrhage had a tendency to occur together with renal dysfunction. For prevention of postoperative renal dysfunction it is important to minimize the renal ischemia, to protect the kidney and to maintain urine output during operation, particularly in patients of preoperative decreased function of kidney and of old male with advanced arteriosclerosis. Also it is necessary to choose the less invasive procedure of operation for patients of severely decreased function of kidney and to consider about organ system relations in patients of postoperative renal dysfunction.

Great interest has been paid to moxibustion from many thousand years ago as one of effective folk medicine, hewever while through the years only practical use has been emphasized, its scientific basis has remained unclear. About 60 years ago Dr. Shimetaro Hara studied on moxibustion histologically and pharmacologically and suspected the widespread meridian theory (theory of Keiraku) in explaination of the moxibustion effect and presented “non-specific heat aggregated autologous tissue protein therapy” theory. It can be said that his theory coincides with today's nonspecific immune regulatory therapy applied to cancer and immune deficient diseases.
Using 9 Week-old femal SLC-Wistar rats, we administered regular moxa moxibustion or electrical moxibustion under the same circumstances as regular moxa moxibustion daily fom definite duration. Following moxibustion, using 0.5mg of HG as an antigen together with Freund's incomplete adjuvant, we sensitized two sites on the foot pads of rats once or twice (2 weeks later).
On the 7th day after the primary or secondary sensitization 1.0mg of HγG in 0.1ml of saline was injected subcutaneously at an intact sites of foot pad and foot pad edema formed was measured periodically. Taking sheep red blood cells and using refined human IgG myeloma protein as an antigen and glutar-aldehyde an a fixing reagent, we admindstered PHA (passive hamagglutination) for the assay of serum antibody level of moxibusted animals.
In comparison with moxibustion, on the same schedule 5mg/kg of levamisole (LEV) was adminstered orally daily and results were examined.
The inflammatory edematous reaction which was induced with the HγG reached a peak 3 hour salter the antigen challenged on the intact foot pad, then gradually weakened until it returned to normal was an immediate type skin reaction.
This edema rection in the moxibustion group and the LEV group also when compared with the control group was significantly stregthened. The antibody titer according to the PHA reaction showed after the primary sensitization, no remarkable increase in the moxibustion group, in fact, the level was about the same as the control. After the secondary sensitization the antibody titer of the moxibustion group was much higher than that of the LEV group compared with the control.
And the strongest effects were obtained in the moxibustion and LEV group. As an immune activator, the functional mechanism of moxibustion compared with levamisole which is said to have some function on the T cells will become clear in the future.
Moreover, it will be clinically possible to use moxibustion as a supplementary therapy to build up the immune response.

Two experiments were performed to clarify the effects of balneotherapy on platelet glutathione metabolism. One experiment, in which healthy men were subjected to water immersion at temperatures of 25°C, 36°C, and 42°C for 10min, showed that the level of platelet lipid peroxides (LPO) tended to increase at 25°C and 42°C, suggesting the presence of oxidative stress at these temperatures. When an antioxidative defense system was induced at these temperatures, the levels of platelet glutathione (GSH), glutathione peroxidase (GPX) and glutathione reductase (GR) activities increased. The other experiment, in which 4 weeks of balneotherapy was applied to type II (non-insulin-dependent) diabetic patients, showed that the level of GSH on admission correlated well with that of fasting plasma glucose (FPG, r=0.692, p<0.050). After 4 weeks of balneotherpy, the level of GSH increased (p<0.01) in well-controlled patients (FPG<150mg/dl) and decreased (p<0.05) in poorly controlled patients (FPG≥150mg/dl), There was a negative correlation between GPX activities and the level of FPG (r=-0.430, p<0.05). After the balneotherapy, the activity increased in five patients, decreased in three patients, and showed no changes in four patients.
These results indicate that, in diabetic patients, 1) platelet GSH synthesis is obviously induced in response to oxidative stress, 2) lowered GPX activities suggest an impaired antioxidative defense system, and 3) platelet glutathione metabolism was partly improved by 4 weeks of balneotherapy but depended on the control status of plasma glucose levels. From these findings, we conclude that 1) patients whose platelet antioxidative defense system is damaged such as those with diabetes mellitus should not take hot or cold bath, and that 2) balneotherapy improves platelet glutathione metabolism, leading to normalization of platelet aggregability.

In atrioventricular (AV) discordance, a morphologic tricuspid valve functioning as a systemic AV valve often becomes incompetent and needs to be replaced. However, mitral valve replacement concomitant with tricuspid valve replacement is unusual in the disease. Here, we report a case of successful double AV valve replacement long after functional biventricular repair in AV discordance. A 32-year-old man with AV discordance was admitted with orthopnea. He had undergone the Rastelli procedure at age 10 and removal of the deteriorated conduit valve at age 24. Preoperative examinations revealed not only tricuspid but also mitral regurgitation. Both deteriorated valves were replaced with mechanical valves. In AV discordance after Rastelli procedure, a non-valved conduit may accelerate mitral deterioration because pulmonary hypertension from tricuspid regurgitation increases the afterload of the pulmonary ventricle.

The inhibitory effects of the freeze-dried powder of the aqueous extract of black tea leaf (JAT) on α-glucosidase activity were investigated. We initially examined the effects of JAT addition on yeast α-glucosidase activity. JAT significantly and dose-dependently inhibited α-glucosidase activity and more strongly inhibited the activity than acarbose, the positive control. Then, we examined the effects of oral administration of JAT on sucrose tolerance in type 2 diabetes mellitus model db/db mice. Both JAT and acarbose administered groups showed a dose-dependent decrease in plasma glucose levels after the sucrose loading compared with the control group. Notable was that the plasma glucose levels of the 500 mg/kg JAT administered group exhibited a significant decrease 30 min or longer after the sucrose loading. On the other hand, no significant difference in plasma insulin levels was seen between the JAT administered group and the control group. We also measured small intestinal sucrase activity in db/db mouse at 30 min after JAT oral administration. Compared to control mice, small intestinal sucrase activity was significantly decreased in the 500 mg/kg JAT administered mice. These findings indicate that JAT may be a useful natural material for the prevention and therapy of type 2 diabetes mellitus.